BHSEA CLINIC INSPECTION FORM

Transcription

1 BEAUTY HEALTH & SKINCARE EMPLOYERS ASSOCIATION Suite 3, Hawkins Centre, 4 Conrad Drive, Blairgowrie, Randburg Telephone (011) Facsimile (011) BHSEA CLINIC INSPECTION FORM NAME OF CLINIC : NAME OF OWNER : NAME OF MANGER / ESS : PHYSICAL ADDRESS : CODE : TELEPHONE No. : CODE : No. : FAX No. : CODE : No. : ADDRESS : WEBSITE ADDRESS : PLEASE LIST ALL THERAPISTS EMPLOYED IN THE CLINIC: Full / Part-time, as well as owner or Manager / ess. NAME Position Membership No

2 THE CLINIC CAN BE RECOMMENDED UNDER: (Please circle) SMALL MEDIUM LARGE HOME SALON 1 2 cubicles 3 4 cubicles 5 or more cubicles TREATMENTS OFFERED: (Please circle) FACIAL ONLY FACIAL AND BODY WAXING/EPILATION ONLY BODY ONLY REMEDIAL ONLY MANICURE/PEDICURES ONLY CLINIC DETAILS : NUMBER OF CUBICLES : HOT AND COLD RUNNING WATER : YES NO (Easily accessible to each Cubicle) STORAGE CUPBOARDS FOR TOWELS AND LINEN : YES NO APPEARANCE OF CLINIC AND DÉCOR : NO SMOKING SIGN DISPLAYED : YES NO SUITABLE FIRE EXTINGUISHER YES NO SUITABLE FLOORING : YES NO Comment SUITABLE VENTILATION : YES NO (Windows or Air Conditioning) DRESS CODE : ALL STAFF IN UNIFORM YES NO DESCRIBE THE ABOVE : BADGE WORN BY ALL THERAPISTS : YES NO GENERAL APPEARANCE OF STAFF :

3 RUNNING OF CLINIC : UP-TO-DATE / ADEQUATE RECORD CARDS WITH REQUIRED INFORMATION : YES NO CONSULTATION FORMS/CARDS IN USE YES NO COMMENTS ON CARDS : STERILISATION : 1. UV STERICAB YES NO 2. AUTOCLAVE YES NO 3. HOT BEAD YES NO 4. SOLUTIONS YES NO 5. OTHER (STATE) : FORMS OF STERILISATION USED PRODUCTS IN USE IN CLINIC: ONE PROFESSIONAL PRODUCT ON DISPLAY FOR RE-SALE : YES NO OTHER PRODUCTS IN USE FOR FACE, BODY, NAILS & WAXING : IT IS COMPULSARY THAT ALL CUBICLES MUST HAVE THE FOLLOWING ACCESSORIES: DUSTBIN; TROLLEY; HANGER; MIRROR; GOWN

4 It is essential that at least two of the following should be provided for treatments: PREHEATING TREATMENTS - BODY - IR / RADIANT HEAT LAMPS - HOT SHOWER - STEAM BATH - HOT TOWELS - SAUNA BLANKET - HEATING PAD - SAUNA - AERATED BATH /JACUZZI - G5 - OTHER : SKIN CARE - CLINICAL PLINTH OR FACIAL COUCH - TROLLEY - STEAMER OR VAPORIZER - DUSTBIN - MAGNIFYING LAMP - HIGH FREQUENCY - GALVANIC UNIT - OTHER : WAXING - CLINICAL PLINTH - HOT WAX / BODY TEMPERATURE UNIT - OTHER : BODY TREATMENTS - CLINICAL PLINTH - FARADIC-TYPE (With at least 8 pairs of pads) / INTERFERENTIAL UNIT - G5 - VACUUM SUCTION

5 - WAXING UNIT - BODY WRAPS - SHOWER - OTHER : ELECTRICAL EPILATION - EPILATION UNIT - MAGNIFYING LAMP - AUTOCLAVE / HOT BEAD SYSTEM - DEPOSIT BOX FOR USED NEEDLES OTHER: MANICURE / PEDICURE - USUAL MANICURE EQUIPMENT - ANTISEPTIC DISINFECTING PRODUCTS - OTHER : LIST OF TREATMENTS AND PRICES AVAILABLE OR ON DISPLAY : YES NO CONTENTS FOR FIRST AID KIT (Please tick) WOUND CLEANER / ANTISEPTIC ADHESIVE DRESSING STRIPS SWABS FOR CLEANING WOUND FIRST AID DRESSING COTTON WOOL FOR PADDING STRAIGHT SPLINTS 1 PACKET STERILE GAUZE SWABS TONGUE DEPRESSORS TWEEZER RESUCITATION AIDS SCISSORS ANALGAESIC SAFETY PINS GERMALANE or BURN SPRAY TRIANGULAR BANDAGES LANCETS ROLLER BANDAGES ELASTIC ADHESIVE ROLL DISPOSABLE GLOVES RECOMMENDATION : AA FIRST AID KIT BHSEA CLINIC RULES STATE THAT ONLY DISPOSABLE NEEDLES / LANCETS TO BE USED ON CLIENTS. (Refer to Clinic Rules & Regulations, points 6 & 7)

6 HAS THIS RULE BEEN BROUGHT TO THE THERAPIST/OWNERS ATTENTION? YES NO ACCORDING TO THE THERAPIST/OWNER ARE THESE RULES ADHERED TO? YES NO ARE THESE RULES ADHERED TO? YES NO (Comment): DETAILED REPORT : COMMENTS ON PASSING / FAILING OF CLINIC DOES THIS CLINIC PASS THE INSPECTION : YES NO ARE THERE ANY CONDITIONS MADE : SIGNATURE - INSPECTOR NAME OF INSPECTOR (PLEASE PRINT) DATE SIGNATURE - WITNESS DATE PLEASE NOTE: SALON OWNERS ARE NOT ADVISING BHSEA WHEN A NEW THERAPIST IS EMPLOYED AND ARE OFTEN NOT BHSEA MEMBERS. THIS MUST BE CHECKED WHEN SALON REINSPECTION IS DONE. BHSEA SALONS SHOULD CARRY AT LEAST ONE PROFFESSIONAL SALON PRODUCT AND RETAIL PRODUCTS SHOULD BE ON DISPLAY AT ALL TIMES WITH REGARDS TO THE DIFFERENT CRITERIA FOR THE DIFFERENT SALONS THIS BASIC FORM STILL APPLIES HOWEVER THE QUALIFICATIONS OF THE THERAPIST MUST BE SAAHSP RECOGNISED AND WE NEED TO BE INFORMED AS TO WHAT THEY ARE.

7 OFFICE USE ONLY NAME OF CLINIC: PAYMENT RECEIVED: YES NO CLINIC FLOOR PLANS: YES NO RECOMMENDATION: ADVERTISING MATERIAL: YES NO PROOF OF FULL MEMBERSHIP OF OWNER / MANAGER / ESS OR ANY EMPLOYEE : YES NO LIST OF ALL EQUIPMENT : YES NO RECOMMENDATION : SIGNATURE DATE